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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Impact of hypertension and diabetes on the onset of chronic kidney disease in a general Japanese population

Hypertension Research volume 46, pages 311–320 (2023)Cite this article

A Comment to this article was published on 06 December 2022

Abstract

Hypertension (HT) and diabetes mellitus (DM) are both major risk factors for chronic kidney disease (CKD); however, few studies have examined the impacts of the combination of HT and DM on CKD development in general populations. We aimed to explore whether HT or DM contributes more to CKD development in a Japanese community. A total of 5823 individuals without a history of CKD who underwent specific health checkups in fiscal year 2013 were monitored until the end of March 2018. Participants were categorized as having neither HT nor DM (none group), either HT or DM, and both (HT + DM). We calculated the hazard ratios (HRs) for developing CKD in each category using Cox proportional hazards models after adjusting for age, dyslipidemia, smoking, and alcohol drinking and with the none group as the reference. We also estimated the population attributable fraction (PAF) for CKD development in populations with either HT or DM or both. During a mean follow-up of 3.0 years, 759 individuals developed CKD, with HRs of 1.56 with a 95% confidence interval (CI) [1.33, 1.83], 1.22 with a 95% CI [0.86, 1.75], and 2.83 with a 95% CI [2.22, 3.63] for the HT only, DM only and HT + DM categories, respectively. Sex-specific analysis showed similar findings. The PAFs for CKD (14.1% and 17.2% for men and women, respectively) were the highest among participants with HT only. We concluded that in this Japanese community, HT contributed more than DM to CKD development; hence, managing hypertension is important to prevent CKD as well as diabetes.

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Acknowledgements

The authors would like to thank the staff at the Habikino City Municipal Office for their important contributions. This study was supported by Comprehensive Research on Cardiovascular and Life-Style Related Disease from the Ministry of Health, Labour and Welfare: Junkankitou–Ippan–22FA1006.

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Authors and Affiliations

  1. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan

    Akira Kaneyama, Aya Hirata, Takumi Hirata, Yukiko Imai, Kazuyo Kuwabara & Tomonori Okamura

  2. Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan

    Takumi Hirata

  3. Habikino City Municipal Office, Osaka, Japan

    Mika Funamoto

  4. Faculty of Nursing and Medical Care, Keio University, Kanagawa, Japan

    Daisuke Sugiyama

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  1. Akira Kaneyama
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Correspondence to Aya Hirata.

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Kaneyama, A., Hirata, A., Hirata, T. et al. Impact of hypertension and diabetes on the onset of chronic kidney disease in a general Japanese population. Hypertens Res 46, 311–320 (2023). https://doi.org/10.1038/s41440-022-01041-9

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